Equipo multidisciplinar de cirugía radioguiada: Alternativa de cambio al paradigma actual / Multidisciplinary radio-guided surgery team: Alternative to change the current paradigm

IntroducciónAnte el aumento constante de la demanda asistencial de exploraciones relacionadas con cirugía radioguiada (CRG), nuestro hospital adoptó incluir en el equipo de CRG nuevos perfiles profesionales con el fin de reducir parcialmente el tiempo de dedicación de los médicos nucleares a esta tarea.Objetivos: Analizar el proceso de incorporación de los perfiles de Técnico Superior en Imagen para el Diagnóstico (TSID) y Enfermera Referente de Ganglio Centinela (ERGC), evaluando su despliegue en los procedimientos ligados a la técnica. Material y métodos: Análisis de la actividad de CRG durante el periodo 2018-2022, centrándolo en los procedimientos prequirúrgicos y quirúrgicos relativos a cáncer de mama (CaM) y melanoma maligno (MM), por ser aquellas patologías en las que se concentró la transferencia de competencias asistenciales. Evolución cronológica de las competencias asumidas por los diferentes perfiles durante su integración en el equipo de CRG. Resultados: La actividad asistencial de CRG durante el periodo analizado experimentó un incremento del 109%. CaM y MM son las patologías que aglutinaron con diferencia una mayor demanda asistencial. La transferencia de competencias en estas dos patologías se ha producido de manera progresiva, asumiendo en 2022 el 74% (460/622) de la fase de administración el ERGC y el 64% (333/519) de las cirugías el TSID. Conclusiones: La creación de un equipo multidisciplinar de CRG, que incluye distintos perfiles profesionales (MN, ERGC y TSID), es una eficaz estrategia para dar respuesta al incremento de la complejidad y número de todos los procedimientos relacionados con la CRG.(AU)

Introduction: Given the constant increase in the healthcare demand for examinations related to radio-guided surgery (RGS), our hospital adopted new professional profiles in the RGS team, in order to partially reduce the time spent by nuclear medicine physicians on this task. Aim: To analyze the process of incorporating the profiles of Superior Diagnostic Imaging Technician (TSID) and Sentinel Node Referent Nurse (ERGC), evaluating their deployment in the procedures linked to the technique. Material and methods: Analysis of RGS activity during the period 2018-2022, focusing on pre-surgical and surgical procedures related to breast cancer (BC) and malignant melanoma (MM), as they are those pathologies on which the transfer of care competencies was concentrated. Chronological evolution of the competencies assumed by the different profiles during their integration into the RGS team. Results: RGS's healthcare activity during the analyzed period experienced an increase of 109%. BC and MM were the pathologies that accounted for by far the greatest demand for care. The transfer of competencies in these two pathologies occurred in a progressive and staggered manner, with 74% (460/622) of the administration phase being carried out by the ERGC and 64% (333/519) of the surgeries by the TSID in 2022. Conclusions: The creation of a multidisciplinary RGS team that includes different professional profiles (NM, ERGC and TSID) is an effective strategy to respond to the increase in the complexity and number of all procedures related to RGS.(AU)

Multidisciplinary radio-guided surgery team: Alternative to change the current paradigm.

INTRODUCTION: Given the constant increase in the healthcare demand for examinations related to radio-guided surgery (RGS), our hospital adopted new professional profiles in the RGS team, in order to partially reduce the time spent by nuclear medicine physicians on this task. AIM: To analyze the process of incorporating the profiles of Diagnostic Imaging Technician (DIT) and Sentinel Node Referent Nurse (SNRN), evaluating their deployment in the procedures linked to the technique. MATERIAL AND METHODS: Analysis of RGS activity during the period 2018-2022, focusing on pre-surgical and surgical procedures related to breast cancer (BC) and malignant melanoma (MM), as they are those pathologies on which the transfer of care competencies was concentrated. Chronological evolution of the competencies assumed by the different profiles during their integration into the RGS team. RESULTS: RGS's healthcare activity during the analyzed period experienced an increase of 109%. BC and MM were the pathologies that accounted for by far the greatest demand for care. The transfer of competencies in these two pathologies occurred in a progressive and staggered manner, with 74% (460/622) of the administration phase being carried out by the SNRN and 64% (333/519) of the surgeries by the DIT in 2022. CONCLUSIONS: The creation of a multidisciplinary RGS team that includes different professional profiles (nuclear medicine physician [MN], ERGC and TSID) is an effective strategy to respond to the increase in the complexity and number of all procedures related to RGS.

Seroprevalence of ANTI-SARS-CoV-2 antibodies in patients with inflammatory bowel disease.

Patients with inflammatory bowel disease (IBD) treated with biologic and/or immunosuppressant drugs are at increased risk for opportunistic infections. Seroprevalence studies can confirm the diagnosis of SARS-CoV-2 infections as well as the associated risk factors. This is a descriptive study which primary endpoints were to highlight the prevalence of SARS-CoV-2 antibodies in a cohort of IBD patients in March 2021, and to analyze seroconversion in patients with known COVID-19 infection and its relationship with IBD treatments. Patients filled in a questionnaire about symptoms of COVID-19 infection and clinical information about their IBD. All included patients were tested for SARS-CoV-2 antibodies. 392 patients were included. Among patients with clinical infection, 69 patients (17,65%) were IgG-positive, 286 (73,15%) IgG-negative and 36 (9,21%) indeterminate. In relation to seroconversion among patients under biologic treatment, 13 patients of the 23 with a previous positive CRP developed antibodies (56.5%). However, when the influence of immunosuppressive treatment on the probability of developing antibodies was analyzed, no significant differences were seen between those patients with or without treatment (77.8% vs. 77.1%, p = 0.96). In our cohort of IBD patients, after one year of pandemic, there were 18.64% IgG positive patients, a higher prevalence than the general population (15.7%).

Particle size and cholesterol content of circulating HDL correlate with cardiovascular death in chronic heart failure.

Evidence regarding any association of HDL-particle (HDL-P) derangements and HDL-cholesterol content with cardiovascular (CV) death in chronic heart failure (HF) is lacking. To investigate the prognostic value of HDL-P size (HDL-Sz) and the number of cholesterol molecules per HDL-P for CV death in HF patients. Outpatient chronic HF patients were enrolled. Baseline HDL-P number, subfractions and HDL-Sz were measured using 1H-NMR spectroscopy. The HDL-C/P ratio was calculated as HDL-cholesterol over HDL-P. Endpoint was CV death, with non-CV death as the competing event. 422 patients were included and followed-up during a median of 4.1 (0-8) years. CV death occurred in 120 (30.5%) patients. Mean HDL-Sz was higher in CV dead as compared with survivors (8.39 nm vs. 8.31 nm, p < 0.001). This change in size was due to a reduction in the percentage of small HDL-P (54.6% vs. 60% for CV-death vs. alive; p < 0.001). HDL-C/P ratio was higher in the CV-death group (51.0 vs. 48.3, p < 0.001). HDL-Sz and HDL-C/P ratio were significantly associated with CV death after multivariable regression analysis (HR 1.22 [95% CI 1.01-1.47], p = 0.041 and HR 1.04 [95% CI 1.01-1.07], p = 0.008 respectively). HDL-Sz and HDL-C/P ratio are independent predictors of CV death in chronic HF patients.

Usefulness of intestinal ultrasound in inflammatory bowel disease. / Utilidad de la ecografía intestinal en la enfermedad inflamatoria intestinal.

Imaging techniques play a fundamental role in the initial diagnosis and follow-up of inflammatory bowel disease. Intestinal ultrasound has high sensitivity and specificity in patients with suspected Crohn's disease and in the detection of inflammatory activity. This technique enables the early diagnosis of intra-abdominal complications such as stenosis, fistulas, and abscesses. It has also proven useful in monitoring the response to treatment and in detecting postsurgical recurrence. Technical improvements in ultrasound scanners, technological advances such as ultrasound contrast agents and elastography, and above all increased experience have increased the role of ultrasound in the evaluation of the gastrointestinal tract. The features that make ultrasound especially attractive include its wide availability, its noninvasiveness and lack of ionizing radiation, its low cost, and its good reproducibility, which is important because it is easy to repeat the study and the study is well tolerated during follow-up. This review summarizes the role of intestinal ultrasound in the detection and follow-up of inflammatory bowel disease.

Influence of fertilisation with foliar urea on the content of amines in wine.

Amines are substances that could cause toxic effects in the consumer. The concentration of amines in wine depends on different factors such as grape variety, vinification conditions and nitrogen fertilisation of the vines. The aim of this work was to study the influence of the application of foliar urea on the concentration of amines in wine. To carry out the study, grapevines of Tempranillo variety were used. These grapevines were treated with foliar urea at two different concentrations: 2 and 4 kg N ha(-1). Treatment with foliar urea significantly increased (p < 0.05) the concentration of histamine in the wines compared with the control sample (65% in the treatment with 2 kg N ha(-1) and 93% in the treatment with 4 kg N ha(-1)), reaching higher concentrations than the threshold level where it could provoke toxic effects in the consumer (8-20 mg l(-1)). On the other hand, treatment with foliar urea did not increase the concentrations of other amines which could be toxic such as tyramine or phenylethylamine, nor amines such as putrescine which could enhance the toxic effect of histamine. In the case of the volatile amines containing secondary amine groups, the concentration of pirrolidine increased by 37% after treatment with 2 kg N ha(-1) and 61% after treatment with 4 kg N ha(-1).

Lateral engineering of surface states - towards surface-state nanoelectronics.

Patterned metal surfaces can host electron quantum waves that display interference phenomena over distances of a few nanometres, thus providing excellent information carriers for future atomic-scale devices. Here we demonstrate that collimation and waveguiding of surface electrons can be realized in silver-induced strain dislocation networks on Cu(111) surfaces, as a conceptual proof-of-principle of surface-state nanoelectronics (SSNE). The Ag/Cu(111) system exhibits featured surface bands with gaps at the Fermi energy, which are basic requirements for a potential SSNE material. We establish a solid analogy between the behavior of surface-state electrons and surface plasmons in patterned metal surfaces, thus facilitating the transfer of existing knowledge on plasmonic structures to the new scenario presented by engineered electronic surface-state nanostructures, with the advantage of a 1000-fold reduction in wavelength and geometrical parameters.

[Needs of the families in a Critical Care Unit]. / Necesidades de los familiares en una Unidad de Cuidados Críticos.

OBJECTIVES: To identify the needs of the family of admitted patients in the Critical Care Unit (CCU), and their level of satisfaction with the attention that they received. DESIGN: Cross-sectional, observational study. SETTING: Critical Care Unit, Virgen Macarena University Hospital, Seville. SUBJECTS OF THE STUDY: Two-hundred and sixty-eight families were selected through a random sampling system. INSTRUMENTS: A survey was developed using bibliography as reference. RESULTS: According to information, it was observed that receiving information after visiting hours and its access was difficult in regards to unforeseen changes in the patient's course. On the other hand, there were high levels of satisfactions with the attention received and with the nursing cares. Nevertheless, several deficiencies were observed in the identification of all the professionals, the visiting hours, the physical conditions of the waiting room, and privacy within patient's care environment. CONCLUSIONS: One of the principal needs of the relatives was to spend more time with the patients. Regarding to the information, access after visiting hours, and on that regarding unforeseen changes in the patient's evolution should be reviewed. Regarding satisfaction, in general, families were highly satisfied with the attention received, especially with the nurse's care. Nevertheless, these professionals should encourage the participation of the families in the patient's care. Moreover, all the areas of improvement observed should be dealt with urgently, mainly the visiting hours.

Necesidades de los familiares en una Unidad de Cuidados Críticos / Needs of the families in a Critical Care Unit

Objetivo. Conocer las necesidades de los familiares de los pacientes ingresados en unaUnidad de Cuidados Críticos (UCC) y su satisfacción con la atención recibida.Diseño. Estudio observacional transversal.Ámbito de estudio. UCC del Hospital Virgen Macarena, ubicado en Sevilla.Sujetos de estudio. Doscientos sesenta y ocho familiares seleccionados mediante unmuestreo aleatorio sistemático.Instrumento. Se elaboró una encuesta en base a la bibliografía.Resultados. En cuanto a la información, se evidenció la dificultad para tener acceso aella fuera de las horas de las visitas y para tener noticia de los cambios imprevistos en laevolución de los pacientes. Por otra parte, se detectaron elevados niveles de satisfaccióncon la atención recibida y con el trato de las enfermeras. No obstante, se observarondeficiencias en la identificación de todos los profesionales, el régimen de visitas, lascondiciones físicas de la sala de espera y la intimidad en el entorno de cuidados delpaciente.Conclusiones. Una de las principales necesidades de los familiares es pasar más tiempocon los pacientes. En cuanto a la información, debería revisarse su accesibilidad fueradel horario de visitas, y la que se ofrece sobre los cambios imprevistos en la evoluciónde los pacientes. Respecto a la satisfacción, en general, los familiares se mostraron altamentesatisfechos con la atención recibida, sobre todo con el trato de las enfermeras.En cualquier caso, estas profesionales deberían favorecer la participación de la familiaen los cuidados del paciente. Además, todas las áreas de mejora que se evidenciaronprecisan de una urgente revisión, en especial, el régimen de visitas(AU)

Objectives. To identify the needs of the family of admitted patients in the Critical CareUnit (CCU), and their level of satisfaction with the attention that they received.Design. Cross-sectional, observational study.Setting. Critical Care Unit, Virgen Macarena University Hospital, Seville.Subjects of the study. Two-hundred and sixty-eight families were selected through arandom sampling system.Instruments. A survey was developed using bibliography as reference.Results. According to information, it was observed that receiving information aftervisiting hours and its access was difficult in regards to unforeseen changes in the patient’scourse. On the other hand, there were high levels of satisfactions with the attentionreceived and with the nursing cares. Nevertheless, several deficiencies were observed inthe identification of all the professionals, the visiting hours, the physical conditions ofthe waiting room, and privacy within patient’s care environment.Conclusions. One of the principal needs of the relatives was to spend more time withthe patients. Regarding to the information, access after visiting hours, and on thatregarding unforeseen changes in the patient’s evolution should be reviewed. Regardingsatisfaction, in general, families were highly satisfied with the attention received,especially with the nurse’s care. Nevertheless, these professionals should encouragethe participation of the families in the patient’s care. Moreover, all the areas ofimprovement observed should be dealt with urgently, mainly the visiting hours(AU)

Electronic states in faceted Au(111) studied with curved crystal surfaces.

Vicinal Au(111) surfaces exhibit periodic faceting within a wide range of miscut angles. There, the system segregates two alternating phases with different step lattice constants d(w) and d(n). Using a curved crystal surface that allows a smooth variation of the surface orientation, we have studied, as a function of the miscut angle, the evolution of Au(111) faceted structures by scanning tunneling microscopy, and their electronic surface states by angle-resolved photoemission. We observe that surface bands reflect the two-phase character of the faceted system, i.e. we find d(w)- and d(n)-like states that evolve accordingly to the faceted structure. Using a photoemission calculation we prove that the apparently complex topology hides relatively simple physics, i.e. the same free-electron-like dispersion and repulsive step scattering that feature surface bands in stepped noble metal surfaces. On the grounds of such simulations, we discuss the possible interference of the electronic energy in the delicate free energy balance that determines the critical size of reconstructed (d(w)) and unreconstructed (d(n)) terraces during Au faceting.

Success rate and patient satisfaction with the Essure sterilisation in an outpatient setting: a prospective study of 857 women.

After 857 women with Essure system inserted for tubal obstruction as a method of sterilization in an outpatient setting, insertion is achieved in close to 99% of the women. Physician described the procedure as very difficult in 15% of the cases, mainly due to anatomical tubal anomalis or tubal spasm, and women felt highly satisfied in all cases.

Cribado del cáncer cervicouterino en colectivos de mujeres asintomáticas con factores de riesgo / Screening for cervical cancer in asymptomatic women with risk factors

Objetivos: Determinar las tasas de patología cervical y vaginal en colectivos de mujeres asintomáticas con factores de riesgo y su grado de adhesión al programa de cribado. Pacientes y métodos: Se asistió a 269 mujeres asintomáticas, reclutadas durante un período de un año (1998), que fueron interrogadas en relación con prácticas de riesgo y sometidas a citología, colposcopia y biopsia de cérvix, y determinación de anticuerpos frente al virus de la inmunodeficiencia humana. Se realizó un seguimiento durante 5 años. Resultados: La prevalencia de lesiones intraepiteliales del cérvix fue del 26,8 por ciento y la incidencia acumulada del 10,4 por ciento. El 62,5 por ciento no volvió a revisión en los 5 años de seguimiento, mientras que el 37,6por ciento volvió al menos una vez. Conclusiones: Las mujeres de los colectivos estudiados presentan altas tasas de patología cervicovaginal y alto riesgo de desarrollar cáncer de cérvix. La adhesión de estas mujeres al programa de cribado es muy baja. Debido a la poca precisión de la citología, estas mujeres deben someterse a una segunda técnica de cribado

Objectives: To determine the rates of cervical and vaginal disease in groups of asymptomatic women with risk factors and their degree of adhesion to the screening program. Patients and methods: 269 asimptomatic women attended during 1 year (1998) were interrogated in relation to risk practices; they underwent pap smear, colposcopy-biopsy of the cervix and determination of antibodies for VIH. A follow-up was made during 5 years. Results: The prevalence of intaepithelial lesions was 26.8 percents and the accumulated incidence was 10.4 percents; 62.5 percents of the women never returned to revision more, whereas 37.6 percents returned at least once. Conclusions: The women of the studied groups show high rates of cervical-vaginal pathology and high risk of developing cervical cancer. The adhesion of these women to the screening program is very low. Because of the low precision of the citology, this women must undergo a second screening test

Scattering of surface states at step edges in nanostripe arrays.

Surface states of noble metal surfaces split into Ag-like and Cu-like subbands in stepped Ag/Cu nanostripe arrays. The latter self-assemble by depositing Ag on vicinal Cu(111). Ag-like states scatter at nude step edges in Ag stripes, leading to umklapp bands, quantum size effects, and peak broadening. By contrast, Ag stripe boundaries become transparent to Cu-like states, which display band dispersion as in flat Cu(111). We find a linear relationship between the quantum size shift and peak broadening that applies in a variety of stepped systems, revealing the complex nature of step barrier potentials.

Fermi gap stabilization of an incommensurate two-dimensional superstructure.

The compressed, incommensurate approximately (9.5 x 9.5) moire superstructure of the Ag monolayer on Cu(111) displays a filled surface state band with a Fermi energy gap at the Brillouin zone boundary. By contrast, the surface band is gapless for the less compressed, commensurate (9 x 9) moire of two Ag layers. A simple estimate of the energy gain rendered by opening this gap gives a value similar to the elastic energy change required to modify the commensurate structure, thereby suggesting that the approximately (9.5 x 9.5) incommensurate phase is stabilized by such a gap opening. The possible presence of a charge density wave state is discussed.

Síndrome de Meigs con valores elevados de CA 125. Aportación de un caso y revisión de la bibliografía / Meig´s syndrome with high levels of CA 125. A case report and literature

Se presenta un caso de síndrome de Meigs en una paciente de 59 años, provocado por un fibroma ovárico. La elevación del antígeno CA 125 y las imágenes ecográficas y de la tomografía axial computarizada hicieron sospechar la presencia de un proceso maligno (AU)

Aplicación del índice pronóstico de Nottingham en el carcinoma de mama operable / Application of the Nottingham Prognostic Index in the operable breast cancer

Evaluar la aplicación del Índice Pronóstico de Nottingham (IPN) en un grupo de mujeres tratadas de carcinoma de mama operable (estadios I, IIa, IIb y IIIa).Se realiza un estudio retrospectivo en 439 pacientes operadas de cáncer de mama, con un seguimiento medio de 73,2 meses, a las que se calculó dicho índice.Se analiza la supervivencia y el tiempo libre de recidiva en función del valor del índice.La supervivencia actuarial a los 8 años para un IPN bueno es del 93,3 por ciento, para un IPN moderado del 88,4 por ciento, y del 75,1 por ciento para un IPN malo (p = 0,01). La recidiva de la enfermedad guarda una relación significativa (p = 0,007) con el valor del índice. Un IPN malo tiene un RR = 2,4 (IC 95 por ciento: 1,6-3,5) para la recidiva y un RR = 2,9 (IC 95 por ciento: 1,3-6,4) para la mortalidad cuando se relaciona con un IPN bueno.Se considera al IPN como un método sencillo y fácilmente reproducible para conocer el pronóstico en las pacientes operadas de cáncer de mama. (AU)

Neuropharmacological profile of a selective sigma ligand, igmesine: a potential antidepressant.

Igmesine is a selective sigma (sigma(1)) ligand that was reported to exert antidepressant action through an unknown mechanism of action. A number of neurochemical measures were taken in this study in efforts to understand its mode of action. Following 21-day drug treatments, the actions of igmesine on a number of neurochemical measures were investigated. Data obtained showed significant decreases in the densities of beta-adrenergic but not 5-HT(1A), sigma(1) and GABA(B) receptors in fluoxetine (18%), desipramine (DMI, 32%) and igmesine (20%)-treated groups when compared with control. Tyrosine hydroxylase (TH) activity was significantly (30-32%) reduced in all treated groups. Further, fluoxetine and DMI excluding the igmesine-treated groups showed 85 and 40% reductions in serotonin (5-HT) and noradrenaline (NE) neuronal uptake, respectively. Following acute treatment, igmesine lacked activity for monoamine oxidase (MAO) A or B (IC(50)>10 microM). In in vivo studies, at behaviorally active doses, igmesine showed weak effects on the NE uptake but lacked activity in altering 5-HT and DA synthesis or antagonizing selective drug-induced depletion of monoamine neuronal uptake. N-methyl-D-aspartate (NMDA)-induced increases in cGMP was blocked by igmesine indicating that igmesine may interfere with the NMDA receptor/nitric oxide synthase/cGMP pathway. Although it appears that part of the pharmacological actions of igmesine is mediated by the monoaminergic system, there is still need to explore other possible mechanisms of antidepressant action.

Design and synthesis of novel quinoxaline-2,3-dione AMPA/GlyN receptor antagonists: amino acid derivatives.

PNQX (1,4,7,8,9,10-hexahydro-9-methyl-6-nitropyrido[3, 4-f]quinoxaline-2,3-dione) is a potent AMPA (IC50 = 0.063 microM) and GlyN (IC50 = 0.37 microM) receptor antagonist that was developed in our laboratories. While possessing a desirable in vitro and in vivo activity profile, this compound suffers from low aqueous solubility. In an effort to improve its potency and physical properties, we have designed and synthesized novel ring-opened analogues 4, 6, 9, and 11. Modeling analyses demonstrated that, while the 5-substituent in these analogues was forced to adopt an out-of-plane conformation due to steric contacts with neighboring substituents, the overall structure retained a good fit to a previously described AMPA pharmacophore model. This nonplanar orientation may lessen efficient packing in the solid state, compared to PNQX, leading to increased water solubility. Indeed, several nonplanar analogues containing appropriate functionalities, for example, the sarcosine analogue 9, were found to retain AMPA (IC50 = 0.14 microM) and GlyN (IC50 = 0.47 microM) receptor affinity and possess improved aqueous solubility compared to PNQX. The synthesis and the SAR of these compounds are discussed.

[Building an agenda for collective oral health] / A construção de uma agenda para a saúde bucal coletiva.

After visiting 14 cities from Brazil where important efforts to improve the SUS (Unified Health System) were being made, the researcher used his main findings to propose a participant agenda-building process for collective oral health, integrated to the new scope of collective health at the municipal level. He notes the strategic role health professionals can play in a new historical proposal for Brazilian society.

Characterization of haloperidol and trifluperidol as subtype-selective N-methyl-D-aspartate (NMDA) receptor antagonists using [3H]TCP and [3H]ifenprodil binding in rat brain membranes.

[3H]TCP and [3H]ifenprodil binding to N-methyl-D-aspartate (NMDA) receptors in rat forebrain membranes was used to compare the inhibition of haloperidol and trifluperidol with that of ifenprodil and eliprodil. In the [3H]TCP binding assay, inhibition curves of ifenprodil, eliprodil, haloperidol and trifluperidol revealed two affinity states in the presence of glutamate, glycine and spermidine. The potency of these agents to inhibit the high-affinity fraction of the binding agreed with the results of other studies investigating their potency to block glutamate-induced current at recombinant NR1a/NR2B NMDA receptors expressed in Xenopus oocytes. These agents also inhibited [3H]ifenprodil binding in a biphasic manner, whether in the absence or the presence of either the sigma site ligand GBR-12909 or spermidine. Spermidine reduced the fraction of high-affinity sites labeled with [3H]ifenprodil. The only alteration in the affinity was a decrease in the IC50 value of haloperidol to inhibit the high-affinity fraction of [3H]ifenprodil binding. GBR-12909 also reduced the fraction of [3H]ifenprodil sites inhibited by these compounds with high affinity, with no change in the affinity for either fraction. These data suggest that spermidine is neither a competitive antagonist at the fraction of the binding inhibited by these agents with high affinity, nor is this fraction of the binding to sigma sites. Haloperidol and trifluperidol represent a new class of agent that interacts at a site that is labeled by [3H]ifenprodil as well as [3H]TCP in rat brain membranes and that closely reflects ifenprodil's voltage-independent site on the recombinant NR1a/NR2B subtype of the NMDA receptor.